Ovarian Cancer Treatment and Clinical Trials
The standard therapies for ovarian cancer include:
Most patients have surgery to remove as much of the tumor as possible. Different types of surgery may include:
- Hysterectomy: A surgical procedure to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
- Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
- Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.
- Omentectomy: A surgical procedure to remove the omentum — a piece of the tissue lining the abdominal wall.
- Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.
Radiation therapy refers to the use of high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. With external radiation therapy, a machine outside your body directs radiation at your cancer. With internal radiation therapy, a radioactive substance sealed in needles, seeds, wires, or catheters is placed inside your body in or near your cancer. Whether you receive internal or external radiation depends on the type and stage of your cancer. Some women instead undergo intraperitoneal radiation therapy, in which radioactive liquid is injected directly in their abdomen through a catheter to kill the cancer or keep it from spreading.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by keeping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy) Delivering anticancer drugs directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube is called intraperitoneal chemotherapy. Whether you receive regional, systemic, or intraperitoneal chemotherapy depends on the type and stage of your cancer.
Treatments in Development
New cancer treatments in development include:
- Biologic therapy: This treatment uses your immune system to fight cancer. The idea is to use substances made by your bodyor replicated in a lab to boost, direct, or restore your body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
- Targeted therapy: This treatment uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are conducted to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Your participation may help improve the way cancer is treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or that reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. To learn more about the clinical trials that Mount Sinai is participating in, type in "ovarian cancer" and click "Search Clinical Trials" on our clinical trials page.
Some of the tests you underwent to diagnose your condition or to determine the stage of your cancer may have to be repeated. Other tests will be repeated to see how well your treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Even after you have completed treatment, your doctor may order tests from time to time to see if your condition has changed or if your cancer has come back. These tests are sometimes called follow-up tests or check-ups. To make an appointment with a Mount Sinai gynecologic oncologist, please call us at 212-427-9898 or 212-241-1111.
National Ovarian Cancer Early Detection Program (NOCEDP)
Mount Sinai leads an international clinical and scientific effort to identify new screening methods for the early detection of epithelial ovarian cancer in high-risk women. Established in 1999, Mount Sinai is only NOCEDP site where gynecologic oncologists are working so closely with genetic counselors.
The hallmark of the program is the coordinated, multidisciplinary services we provide during each comprehensive clinic visit including evaluations by board certified specialists in cancer genetics, gynecologic oncology, ultrasound, and psychology. Participants receive a consultation with a board certified genetic counselor that reviews the family history of cancer in detail and provides an estimate of the likelihood of hereditary susceptibility.
We also provide women and their families the opportunity to discuss the numerous and complicated issues surrounding genetic testing. Women who participate in the program return every six months for follow-up, but remain with their own gynecologists for routine care.
To make an appointment with a Mount Sinai gynecologic oncologist in our National Ovarian Cancer Early Detection Program, please contact us at 212-427-9898.
To make an appointment with a Mount Sinai gynecologic oncologist, please contact us at 212-427-9898.
David Fishman, MD, writes about ovarian cancer and how early detection can significantly increase the rate of survival. Learn more